微创术治疗高血压性脑出血的临床研究

Clinical study of treatment with mini-invasive operation for hypertensive cerebral hemorrhage

目的 研究颅内血肿微创清除术治疗高血压性脑出血的方法、适应症、效果。方法 对符合条件的 12 0例高血压性脑出血患者入院时随机分为微创组和保守组 ,各 6 0例。结果 微创组血肿完全或大部分吸收提前到 1～ 2周者占 78.0 % ,而保守组无 1例 ;微创组死亡率占 2 0 .0 % ,明显低于保守组的 4 1.7% (P <0 .0 5 ) ;微创组的意识恢复快 ,住院时间短及半年后生活能力强等方面均明显优于保守组 (P <0 .0 1)。微创组术后再出血 15 .0 % ,高于保守组的 10 .0 % ,但 75 %发生在 2 4h以内 ,手术时机以6～ 72h为宜。结论 选用微创术治疗高血压性脑出血操作简便 ,疗效好 ,宜于推广。

Objective To investigate the treatment methods and effects of minitraumatic operation with cerebal hemorrhage.Method One hundred and twenty with patients cerebral hemorrage were randomly divided into two groups:minitraumatic operation group and controlled group.Results Compared with the controlled group,the cerebral hematoma absorptive rate was remarkably promoted in the operation group.The time of absorptive hematoma in the operation group was significantly earlier than that in the controlled group.There was significant difference between the two groups in the mortality rates.The mortality rates in the operation group and the controlled group was 20.0% and 41.7% respectively.The grade of the living abilities of the operation group was higher than that in controlled group after followed up for half a year(P<0.01).The opportunity of operating was the period between 6h and 72h.Conclusion The treatment with minitraumatic operation on cerebral hemorrhage patients is very effective and may be considered the best choice.